There is no nursing shortage
- page 2

This is what my teacher told us. She said there are plenty of nurses out there to take care of the future rising amount of patients, its just that they are not working. They have quit (more than... Read More

Nov 16, '06

(i forgot to quote the original poster)

no nursing shortage?! perhaps it may seem that we don't have a current nursing shortage now because of all the nurses listed (working or not), but the concerns of a nursing shortage are of those nurses who won't be able to work anymore and for the future in general.

two main issues behind these concerns: 1) many current nurses are aging and growing old (est. average age is about 46.8 yrs old), and 2) the overall population is growing old too. one main reason behind both issues: the baby boomers. you've all learned about the baby boomers in history class. birth rates rose an enormous amount between 1945-1957. we are the generation to replace them and to care for them.

your teacher mentioned that there are nurses out there who are not working due to poor work environments- did she provide a specific percentage and source? yes, some nurses may have stopped working because of it, but not that large of an amount to be able to join current nurses to handle the future's older age group. how many of those nurses that stopped working are older than 30? i'm sure the majority of those nurses are within the baby boomer ages.

many of you have already listed SIGNIFICANT contributing factors as well, like: poor working conditions/benefits/compensations (avoiding to work at specific hospitals and even avoiding to work as a nurse!), RNs finding interests in other fields (business, management positions), shortage of teachers in nursing programs, etc. it's harder to address solutions for some of these issues.

aging nurses + large aging population= many, many old patients to care for and few nurses to care for them. yes, many of these nurses will work until they drop, but then it comes down to issues of safety and reliability. it's just a matter of figuring out that we'll have a nursing shortage and putting all the pieces together.

no nursing shortage?! perhaps it may seem that we don't have a current nursing shortage now because of all the nurses listed (working or not), but the concerns of a nursing shortage are of those nurses who won't be able to work anymore and for the future in general.

two main issues behind these concerns: 1) many current nurses are aging and growing old (est. average age is about 46.8 yrs old), and 2) the overall population is growing old too. one main reason behind both issues: the baby boomers. you've all learned about the baby boomers in history class. birth rates rose an enormous amount between 1945-1957. we are the generation to replace them and to care for them.

your teacher mentioned that there are nurses out there who are not working due to poor work environments- did she provide a specific percentage and source? yes, some nurses may have stopped working because of it, but not that large of an amount to be able to join current nurses to handle the future's older age group. how many of those nurses that stopped working are older than 30? i'm sure the majority of those nurses are within the baby boomer ages.

many of you have already listed SIGNIFICANT contributing factors as well, like: poor working conditions/benefits/compensations (avoiding to work at specific hospitals and even avoiding to work as a nurse!), RNs finding interests in other fields (business, management positions), shortage of teachers in nursing programs, etc. it's harder to address solutions for some of these issues.

aging nurses + large aging population= many, many old patients to care for and few nurses to care for them. yes, many of these nurses will work until they drop, but then it comes down to issues of safety and reliability. it's just a matter of figuring out that we'll have a nursing shortage and putting all the pieces together.

The one thing missing from all of this is the issue of money. Right now, we are a medicare driven health care system. On average, 75% of all hospital admits are medicare patients. Fed Chairman, Bernanski, has testified before Congress that it is impossible to provide the same level of medicare coverage for the Baby Boomers as has been provided for past elderly. If Boomers don't have money, and Boomers have limited benefits from medicare, do you think hospitals and doctors are going to provide free care, or ignore 75% of the bill? In the past, most nurses have stopped working by age 60. I'm 53 and my estimated SS benefits at age 62 are $700 per month. Do you honestly think I'm going to quit working and live on $700 a month AND pay healthcare costs? Get real. I will have to work until I'm 70 and so I better start figuring out how. Boomers will not retire as predicted!!

Another thing the "nursing shortage" advocates leave out is that last year 350,000 Americans went out of the country for medical procedures. Apollo Hospitals in India are state of the art, and are just an example of the competition out there. Their physicians are trained in the US. They charge $6500 for open heart surgery, and with that you get a private room and private duty RN's around the clock. With plane tickets, you are looking at $10K. In the US, you can't touch this surgery for less than $60K. All it takes is a large company like Ford, GM, or IBM ,that are international companies anyway, to start insisting that employees shop the proceedure and go with the cheapest or you, the employee, pay the difference. Insurance benefits will become Health Savings Accounts and if an employee has only $10K saved up and needs open heart, he's going to India.

IT IS ALL ABOUT THE MONEY. Boomers won't retire as predicted. Medicare won't pay as they have in the past. People won't continue to pay high prices here in the US if they can get better care someplace else. If people aren't paying their healthcare bills, how many hospitals can stay in business? And, if there are fewer hospitals, there will be fewer nursing jobs since over half of all nurses work in hospitals. Many nurses will become Nurse Practitioners and you will see a NP before being referred to an MD. MD's won't be able to afford the nursing staffs they currently have in the future. Jan 2006, Congress approved changes to medicare that prevents elderly people from putting assets in their children's names to protect those assets if they have to go to a nursing home. People will now have to use all their assets first before medicare will kick in and start paying. Just might be incentive for the kids to keep dear old mom home. Less LTC.

Another thing the "nursing shortage" advocates leave out is that last year 350,000 Americans went out of the country for medical procedures. Apollo Hospitals in India are state of the art, and are just an example of the competition out there. Their physicians are trained in the US.

True but, you also don't have the same patient rights in India. There, the MD calls the shots. We have a lot of Indian docs in my area and, for the new ones who've just come over here, it takes them awhile to realize that patients ultimately make the decisions in the U.S. I wonder how these U.S. patients will feel when they can't make their own decisions in India.

They charge $6500 for open heart surgery, and with that you get a private room and private duty RN's around the clock. With plane tickets, you are looking at $10K. In the US, you can't touch this surgery for less than $60K. All it takes is a large company like Ford, GM, or IBM ,that are international companies anyway, to start insisting that employees shop the proceedure and go with the cheapest or you, the employee, pay the difference. Insurance benefits will become Health Savings Accounts and if an employee has only $10K saved up and needs open heart, he's going to India.

I see your point about the economics here. But, seriously, how many open hearts are actually ambulatory. How many are actually capable of travel? Not that many. And, even if they are ... are the planes going to be equipped with medical personnel and equipment if they code? Who's liable if they die during travel?

There's all kinds of sticky situations that could happen here. Seems like this would only be feasible for elective, non-emergent surgeries. And, of course, you'd have to convince the average American worker to get his surgery in India ...

Maybe they'll do it if they don't have insurance and have to pay for it themselves but, who's going to pay for an insurance plan that mandates surgery in India? Given a choice, it doesn't seem likely.

True but, you also don't have the same patient rights in India. There, the MD calls the shots. We have a lot of Indian docs in my area and, for the new ones who've just come over here, it takes them awhile to realize that patients ultimately make the decisions in the U.S. I wonder how these U.S. patients will feel when they can't make their own decisions in India.

I see your point about the economics here. But, seriously, how many open hearts are actually ambulatory. How many are actually capable of travel? Not that many. And, even if they are ... are the planes going to be equipped with medical personnel and equipment if they code? Who's liable if they die during travel?

There's all kinds of sticky situations that could happen here. Seems like this would only be feasible for elective, non-emergent surgeries. And, of course, you'd have to convince the average American worker to get his surgery in India ...

Maybe they'll do it if they don't have insurance and have to pay for it themselves but, who's going to pay for an insurance plan that mandates surgery in India? Given a choice, it doesn't seem likely.

:typing

Well, 350,000 didn't have a problem with going out of the country last year. Imagine if that doubled. 44 million people in this country have NO health insurance and there are 77 million Boomers that may not have much insurance either. The math is that healthcare in this country has priced itself out of the market and we nurses are going to soon feel it.

Well, 350,000 didn't have a problem with going out of the country last year. Imagine if that doubled. 44 million people in this country have NO health insurance and there are 77 million Boomers that may not have much insurance either. The math is that healthcare in this country has priced itself out of the market and we nurses are going to soon feel it.

I'm not underestimating the trend. I just think it's going to be limited. Even if the numbers doubled it would still be a fraction of the millions of surgeries done each each year. When you look at the people who are having these overseas surgeries, it's mostly relatively healthy patients who need minor, elective surgeries.

But when you look at the average hospital patient, these are typically high acuity patients, where the acuity is only getting higher, not lower. I just don't see how those elderly, high acuity patients are going to be shipped off to India in any great numbers.

As far as costs ... what really needs to happen at home is cutting off free services for illegal immigrants. In California, for example, that's what's killing the hospitals more than anything else. And all of this free healthcare drives up the costs of procedures for those who do pay.

With the public outcry over illegals, and some states already passing initiatives limiting illegals' access to free healthcare ... I personally would bet on free healthcare for illegals being cut off over the next 20 years before Americans will be shipped off to India in any significant numbers.

:typing

Last edit by Sheri257 on Nov 17, '06

Nov 17, '06

About the increasing number of patients going overseas to have surgery done-the last news item I saw about this indicated that 98% of these procedures were cosmetic/plastic surgeries and that the majority were part of packaged vacation plans-get your breast implants, get over your swelling, and lie to your friends about where you've been for three weeks.Plastic surgery is an all cash business without the hassles of insurance so foreign doctors like American ones love these patients. When you consider the stressors on families when their loved ones have surgery in a hospital 15 minutes away from their front door, imagine how that is multiplied when their loved one is 3000 miles away from them and they can't afford that $2500 airplane ticket and the lodging costs associated with a length recovery. And imagine how warm and fuzzy they will feel when they're told they have no recourse when their loved one is injured through negligence on the MDs part. It's not as simplistic as saying we're pricing ourselves out of the healthcare pie.